An Integrative, Evidence-based Model of Cultural Competency Training in Latino Health across the Continuum of Medical Education will address cultural competency training amongst medical students, residents and faculty using an integrative institutional approach. Data from trainees in an immersion model providing culturally competent care, the Program in Medical Education for Latino Communities (PRIME-LC) will be the gold standard. The focus is cardiovascular and pulmonary disease care and prevention which have high prevalence amongst Latinos. 1. UME. Conduct curriculum-wide needs assessment, identify courses for improving awareness (sensitivity), knowledge (multicultural/categorical) and skill sets (cross-cultural). We will pilot test new case-based instruction, then implement in the general curriculum in years 3 - 5. Instructional methods will include problem-based learning, workshops, field experiences, assessment with skill-based methods: standardized patients in the Clinical Practice Examination, direct observation of practice and patient feedback. Instruction on health disparities will be delivered in existing courses. 2. GME. Enhance skill-based competencies using rigorous methods: observation of care, chart reviews and patient satisfaction surveys. Cultural competency training modules will be developed and pilot-tested in primary care residencies, then progressively implemented in other residencies. 3. CME. Include evidence-based data on disparities as a routine part of CME programs at UCI and develop a database of discipline-specific disparities information. Faculty development delivered in two annual workshops will be part of the institutional integration model. 4. Rigorous Evaluation - Develop and share instruments for learner and program evaluation to track curricular impact. The most effective instructional and evaluation methods will be identified for dissemination using both process and outcome measures. A central web resource will disseminate case-based instruction and relevant pertinent research on health disparities.